Skip to main content
main-content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 8/2012

01.08.2012 | Handsurgery

Tuberculous extensor tenosynovitis of the hand

verfasst von: Florian A. Probst, Michael Koch, Jörn Lohmeyer, Hans-Günther Machens, Jan-Thorsten Schantz

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 8/2012

Einloggen, um Zugang zu erhalten

Abstract

Tuberculous tenosynovitis is a rare manifestation of extrapulmonary tuberculosis (Tb), especially if solely the dorsal hand compartment is affected. In this report, we present the medical history of an immuno-competent 32-year-old man presented with a painful swelling of the right dorsal wrist. Initial inflammation onset had occurred 6 months before he consulted our service, resulting in consultation of several physicians and extensive diagnostic procedures without gaining a specific diagnosis. Finally, after extensive diagnostic tests, a tenosynovectomy was performed and tuberculosis-induced extensor tenosynovitis was detected. The diagnosis was established by positive histology, repeated specific PCR and T-SPOT.TB. Tuberculous tenosynovitis can easily be overlooked as a cause of chronic tenosynovitis particularly in immunocompetent young people lacking any risk factors.
Literatur
1.
Zurück zum Zitat McDonald LS, Bavaro MF, Hofmeister EP, Kroonen LT (2011) Hand infections. J Hand Surg Am 36:1403–1412 PubMedCrossRef McDonald LS, Bavaro MF, Hofmeister EP, Kroonen LT (2011) Hand infections. J Hand Surg Am 36:1403–1412 PubMedCrossRef
2.
Zurück zum Zitat Batra S, Ab Naell M, Barwick C, Kanvinde R (2007) Tuberculous pyomyositis of the thigh masquerading as malignancy with concomitant tuberculous flexor tenosynovitis and dactylitis of the hand. Singap Med J 48:1042–1046 Batra S, Ab Naell M, Barwick C, Kanvinde R (2007) Tuberculous pyomyositis of the thigh masquerading as malignancy with concomitant tuberculous flexor tenosynovitis and dactylitis of the hand. Singap Med J 48:1042–1046
3.
Zurück zum Zitat Soler R, Rodriguez E, Remuinan C, Santos M (2001) MRI of musculoskeletal extraspinal tuberculosis. J Comput Assist Tomogr 25:177–183 PubMedCrossRef Soler R, Rodriguez E, Remuinan C, Santos M (2001) MRI of musculoskeletal extraspinal tuberculosis. J Comput Assist Tomogr 25:177–183 PubMedCrossRef
4.
Zurück zum Zitat Tuli SM (2002) General principles of osteoarticular tuberculosis. Clin Orthop Relat Res 398:11–19 PubMedCrossRef Tuli SM (2002) General principles of osteoarticular tuberculosis. Clin Orthop Relat Res 398:11–19 PubMedCrossRef
5.
6.
Zurück zum Zitat Albornoz MA, Mezgarzedeh M, Neumann CH, Myers AR (1998) Granulomatous tenosynovitis: a rare musculoskeletal manifestation of tuberculosis. Clin Rheumatol 17:166–169 PubMedCrossRef Albornoz MA, Mezgarzedeh M, Neumann CH, Myers AR (1998) Granulomatous tenosynovitis: a rare musculoskeletal manifestation of tuberculosis. Clin Rheumatol 17:166–169 PubMedCrossRef
7.
Zurück zum Zitat Gonzalez-Gay MA, Garcia-Porrua C, Cereijo MJ, Rivas MJ, Ibanez D, Mayo J (1999) The clinical spectrum of osteoarticular tuberculosis in non-human immunodeficiency virus patients in a defined area of northwestern Spain (1988–1997). Clin Exp Rheumatol 17:663–669 PubMed Gonzalez-Gay MA, Garcia-Porrua C, Cereijo MJ, Rivas MJ, Ibanez D, Mayo J (1999) The clinical spectrum of osteoarticular tuberculosis in non-human immunodeficiency virus patients in a defined area of northwestern Spain (1988–1997). Clin Exp Rheumatol 17:663–669 PubMed
8.
Zurück zum Zitat Aboudola S, Sienko A, Carey RB, Johnson S (2004) Tuberculous tenosynovitis. Hum Pathol 35:1044–1046 PubMedCrossRef Aboudola S, Sienko A, Carey RB, Johnson S (2004) Tuberculous tenosynovitis. Hum Pathol 35:1044–1046 PubMedCrossRef
9.
Zurück zum Zitat Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Omawi M (2011) Tuberculosis of the hand. J Hand Surg Am 36:1413–1421 PubMedCrossRef Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Omawi M (2011) Tuberculosis of the hand. J Hand Surg Am 36:1413–1421 PubMedCrossRef
10.
Zurück zum Zitat Visuthikosol V, Kruavit A, Nitiyanant P, Siriwongpairat P (1996) Tuberculous infection of the hand and wrist. Ann Plast Surg 37:55–59 PubMedCrossRef Visuthikosol V, Kruavit A, Nitiyanant P, Siriwongpairat P (1996) Tuberculous infection of the hand and wrist. Ann Plast Surg 37:55–59 PubMedCrossRef
11.
Zurück zum Zitat Fnini S, Ouarab M, Rafai M, Cohen D, Largab A, Trafeh M (1999) An uncommon occupational accident: tuberculous tenosynovitis of the extensor tendons of the hand. Chir Main 18:309–312 PubMed Fnini S, Ouarab M, Rafai M, Cohen D, Largab A, Trafeh M (1999) An uncommon occupational accident: tuberculous tenosynovitis of the extensor tendons of the hand. Chir Main 18:309–312 PubMed
12.
Zurück zum Zitat Kriegs-Au G, Ganger R, Petje G (2003) The sequelae of late diagnosis in tuberculous flexor tenosynovitis of the hand—a report of 2 cases. Acta Orthop Scand 74:221–224 PubMedCrossRef Kriegs-Au G, Ganger R, Petje G (2003) The sequelae of late diagnosis in tuberculous flexor tenosynovitis of the hand—a report of 2 cases. Acta Orthop Scand 74:221–224 PubMedCrossRef
13.
Zurück zum Zitat Hsu CY, Lu HC, Shih TT (2004) Tuberculous infection of the wrist: MRI features. AJR Am J Roentgenol 183:623–628 PubMed Hsu CY, Lu HC, Shih TT (2004) Tuberculous infection of the wrist: MRI features. AJR Am J Roentgenol 183:623–628 PubMed
14.
Zurück zum Zitat Kotwal PP, Khan SA (2009) Tuberculosis of the hand: clinical presentation and functional outcome in 32 patients. J Bone Joint Surg Br 91:1054–1057 PubMedCrossRef Kotwal PP, Khan SA (2009) Tuberculosis of the hand: clinical presentation and functional outcome in 32 patients. J Bone Joint Surg Br 91:1054–1057 PubMedCrossRef
15.
Zurück zum Zitat Garrido G, Gomez-Reino JJ, Fernandez-Dapica P, Palenque E, Prieto S (1988) A review of peripheral tuberculous arthritis. Semin Arthr Rheum 18:142–149 CrossRef Garrido G, Gomez-Reino JJ, Fernandez-Dapica P, Palenque E, Prieto S (1988) A review of peripheral tuberculous arthritis. Semin Arthr Rheum 18:142–149 CrossRef
16.
Zurück zum Zitat Subasi M, Bukte Y, Kapukaya A, Gurkan F (2004) Tuberculosis of the metacarpals and phalanges of the hand. Ann Plast Surg 53:469–472 PubMedCrossRef Subasi M, Bukte Y, Kapukaya A, Gurkan F (2004) Tuberculosis of the metacarpals and phalanges of the hand. Ann Plast Surg 53:469–472 PubMedCrossRef
17.
Zurück zum Zitat Daigeler A, Lehnhardt M, Helwing M, Steinstraesser L, Homann H-H, Steinau H-U, Druecke D (2006) Differential diagnosis of “sterile” phlegmonous hand infections. Chirurg 77:1040–1045 PubMedCrossRef Daigeler A, Lehnhardt M, Helwing M, Steinstraesser L, Homann H-H, Steinau H-U, Druecke D (2006) Differential diagnosis of “sterile” phlegmonous hand infections. Chirurg 77:1040–1045 PubMedCrossRef
18.
Zurück zum Zitat Dhammi IK, Singh S, Jain AK, Kumar S (2006) Isolated tuberculous tenosynovitis of the flexor carpi ulnaris: a case report and review of literature. Acta Orthop Belg 72:779–782 PubMed Dhammi IK, Singh S, Jain AK, Kumar S (2006) Isolated tuberculous tenosynovitis of the flexor carpi ulnaris: a case report and review of literature. Acta Orthop Belg 72:779–782 PubMed
19.
Zurück zum Zitat Hassanpour SE, Gousheh J (2006) Mycobacterium tuberculosis-induced carpal tunnel syndrome: management and follow-up evaluation. J Hand Surg Am 31:575–579 PubMedCrossRef Hassanpour SE, Gousheh J (2006) Mycobacterium tuberculosis-induced carpal tunnel syndrome: management and follow-up evaluation. J Hand Surg Am 31:575–579 PubMedCrossRef
20.
Zurück zum Zitat Bush DC, Schneider LH (1984) Tuberculosis of the hand and wrist. J Hand Surg Am 9:391–398 PubMed Bush DC, Schneider LH (1984) Tuberculosis of the hand and wrist. J Hand Surg Am 9:391–398 PubMed
21.
Zurück zum Zitat Pang HN, Lee JY, Puhaindran ME, Tan SH, Tan AB, Yong FC (2007) Mycobacterium marinum as a cause of chronic granulomatous tenosynovitis in the hand. J Infect 54:584–588 PubMedCrossRef Pang HN, Lee JY, Puhaindran ME, Tan SH, Tan AB, Yong FC (2007) Mycobacterium marinum as a cause of chronic granulomatous tenosynovitis in the hand. J Infect 54:584–588 PubMedCrossRef
22.
Zurück zum Zitat Cheung JP, Fung B, Wong SS, Ip WY (2010) Review article: Mycobacterium marinum infection of the hand and wrist. J Orthop Surg (Hong Kong) 18:98–103 Cheung JP, Fung B, Wong SS, Ip WY (2010) Review article: Mycobacterium marinum infection of the hand and wrist. J Orthop Surg (Hong Kong) 18:98–103
23.
Zurück zum Zitat Kang GC, Gan AW, Yam A, Tan AB, Tay SC (2010) Mycobacterium abscessus hand infections in immunocompetent fish handlers: case report. J Hand Surg Am 35:1142–1145 PubMedCrossRef Kang GC, Gan AW, Yam A, Tan AB, Tay SC (2010) Mycobacterium abscessus hand infections in immunocompetent fish handlers: case report. J Hand Surg Am 35:1142–1145 PubMedCrossRef
24.
Zurück zum Zitat Sánchez R, Font B, Pi J (2010) Mycobacterium xenopi flexor tenosynovitis. J Hand Surg Eur Vol 35:516–517 PubMedCrossRef Sánchez R, Font B, Pi J (2010) Mycobacterium xenopi flexor tenosynovitis. J Hand Surg Eur Vol 35:516–517 PubMedCrossRef
25.
Zurück zum Zitat Moores CD, Grewal R (2011) Radical surgical debridement alone for treatment of carpal tunnel syndrome caused by mycobacterium avium complex flexor tenosynovitis: case report. J Hand Surg Am 36:1047–1051 PubMedCrossRef Moores CD, Grewal R (2011) Radical surgical debridement alone for treatment of carpal tunnel syndrome caused by mycobacterium avium complex flexor tenosynovitis: case report. J Hand Surg Am 36:1047–1051 PubMedCrossRef
26.
Zurück zum Zitat Senda H, Muro H, Terada S (2011) Flexor tenosynovitis caused by Mycobacterium arupense. J Hand Surg Eur Vol 36:72–73 PubMedCrossRef Senda H, Muro H, Terada S (2011) Flexor tenosynovitis caused by Mycobacterium arupense. J Hand Surg Eur Vol 36:72–73 PubMedCrossRef
27.
Zurück zum Zitat Marques VB, Vieira HP, Alcantara AC, Braga FN, Rocha FA, Medeiros MC (2010) Tenosynovitis and carpal tunnel syndrome from mycobacterium tuberculosis—a rare manifestation of extrapulmonary tuberculosis. Acta Reumatol Port 35:82–84 PubMed Marques VB, Vieira HP, Alcantara AC, Braga FN, Rocha FA, Medeiros MC (2010) Tenosynovitis and carpal tunnel syndrome from mycobacterium tuberculosis—a rare manifestation of extrapulmonary tuberculosis. Acta Reumatol Port 35:82–84 PubMed
28.
Zurück zum Zitat Woon CY, Phoon ES, Lee JY, Puhaindran ME, Peng YP, Teoh LC (2011) Rice bodies, millet seeds, and melon seeds in tuberculous tenosynovitis of the hand and wrist. Ann Plast Surg 66:610–617 PubMedCrossRef Woon CY, Phoon ES, Lee JY, Puhaindran ME, Peng YP, Teoh LC (2011) Rice bodies, millet seeds, and melon seeds in tuberculous tenosynovitis of the hand and wrist. Ann Plast Surg 66:610–617 PubMedCrossRef
29.
Zurück zum Zitat Sanal HT, Zor F, Kocaoğlu M, Bulakbaşi N (2009) Atypical mycobacterial tenosynovitis and bursitis of the wrist. Diagn Interv Radiol 15:266–268 PubMed Sanal HT, Zor F, Kocaoğlu M, Bulakbaşi N (2009) Atypical mycobacterial tenosynovitis and bursitis of the wrist. Diagn Interv Radiol 15:266–268 PubMed
30.
Zurück zum Zitat Meier T, Eulenbruch HP, Wrighton-Smith P, Enders G, Regnath T (2005) Sensitivity of a new commercial enzyme-linked immunospot assay (T SPOT-TB) for diagnosis of tuberculosis in clinical practice. Eur J Clin Microbiol Infect Dis 24:529–536 PubMedCrossRef Meier T, Eulenbruch HP, Wrighton-Smith P, Enders G, Regnath T (2005) Sensitivity of a new commercial enzyme-linked immunospot assay (T SPOT-TB) for diagnosis of tuberculosis in clinical practice. Eur J Clin Microbiol Infect Dis 24:529–536 PubMedCrossRef
31.
Zurück zum Zitat van Leeuwen RM, Bossink AW, Thijsen SF (2007) Exclusion of active Mycobacterium tuberculosis complex infection with the T-SPOT.TB assay. Eur Respir J 29:605–607 PubMedCrossRef van Leeuwen RM, Bossink AW, Thijsen SF (2007) Exclusion of active Mycobacterium tuberculosis complex infection with the T-SPOT.TB assay. Eur Respir J 29:605–607 PubMedCrossRef
32.
Zurück zum Zitat Chakravorty S, Sen MK, Tyagi JS (2005) Diagnosis of extrapulmonary tuberculosis by smear, culture, and PCR using universal sample processing technology. J Clin Microbiol 43:4357–4362 PubMedCrossRef Chakravorty S, Sen MK, Tyagi JS (2005) Diagnosis of extrapulmonary tuberculosis by smear, culture, and PCR using universal sample processing technology. J Clin Microbiol 43:4357–4362 PubMedCrossRef
33.
Zurück zum Zitat Karunadasa KP, Dissanayake DA, Beneragama TS, Perera D (2010) Staged flexor tendon reconstruction in a patient with caseous tuberculous tenosynovitis. J Hand Surg Eur Vol 35:515–516 PubMedCrossRef Karunadasa KP, Dissanayake DA, Beneragama TS, Perera D (2010) Staged flexor tendon reconstruction in a patient with caseous tuberculous tenosynovitis. J Hand Surg Eur Vol 35:515–516 PubMedCrossRef
Metadaten
Titel
Tuberculous extensor tenosynovitis of the hand
verfasst von
Florian A. Probst
Michael Koch
Jörn Lohmeyer
Hans-Günther Machens
Jan-Thorsten Schantz
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 8/2012
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-012-1527-2

Weitere Artikel der Ausgabe 8/2012

Archives of Orthopaedic and Trauma Surgery 8/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, DICOM-Daten, Videos und Abbildungen. » Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.